Older women, especially those over age 75, are the fastest growing segment of the population. Many of these women will be living with breast cancer because the incidence of this disease increases with age. Unfortunately, the research on adaptation to illness, symptom management, and quality of life of women with breast cancer has focused on woman under 65. Unlike younger women, older women with BC experience symptoms of their disease and its treatment concurrent with symptoms of age-related chronic illnesses. Thus, they are faced with the unique challenge of sorting out and managing a variety of complex and sometimes confusing symptoms. We propose to test an individualized representational intervention (IRIS) to improve symptom management and quality of life in older women with breast cancer. The theoretical basis of the intervention is Leventhal's Common Sense Model, with the addition of strategies for conceptual change. Leventhal's Common Sense Model suggests that individuals' representations of their symptoms are critical determinants of how they cope with them. By addressing women's representations, we hope to change beliefs that interfere w3ith adequate symptom management, assist women in developing individualized, effective symptom management strategies and thereby improve quality of life. Participants in this study will be women aged 65 and older who are at least one year post-diagnosis of BC. They will be randomized to one of three conditions: a representational intervention (IRIS) delivered by an advanced practice nurse in a counseling interview, an attention-only control group, or usual care. Measures of symptom distress, helpfulness of symptom management activities, and quality of life will be taken at baseline, six weeks and ten weeks post intervention. We predict that IRIS will improve symptom management, which will in turn improve quality of life for older women with breast cancer.